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Background: Meropenem resistance of Pseudomonas aeruginosa (P. aeruginosa) is considered an increasing problem. Efflux pump is one of multiple mechanisms that are responsible for this resistance. This study aimed to phenotypically and genotypically detect prevalence of efflux pump mediated meropenem resistance among P. aeruginosa isolates. Methods: Pseudomonas aeruginosa was isolated from different clinical specimens and identified by conventional methods and confirmed by Viètek MS Malditof Mass Spectroscopy. Antibiotic susceptibility test was done by disc diffusion method then minimum inhibitory concentrations (MIC) for meropenem was detected twice by agar dilution method without and after addition of carbonyl cyanide m-chlorophenylhydrazone (CCCP). Efflux pump genes were detected by polymerase chain reaction ( PCR). Results: Out of 265 specimens, 78 P. aeruginosa were isolated with an isolation rate (29.4%). By disc diffusion method and MIC by agar dilution methods, 35 (44.8%) isolates were meropenem resistant. There was a significant difference regarding distribution of efflux pump genes in meropenem resistant isolates as 23 isolates (65.7%) were positive for efflux pump genes and 12 (34.3%) were negative (p value= 0.13). The MICs of meropenem for P. aeruginosa isolates were significantly decreased after addition of CCCP where MIC of 21 (60%) meropenem resistant isolates had an efflux pumpoverexpressing phenotype (p value =0.001). Conclusion: High prevalence of meropenem resistance in P. aeruginosa is mediated by efflux pump genes including, mex A, mex B and opr M.

BackgroundGroup B streptococcus (GBS) is one of the main causes of neonatal sepsis.PurposeEvaluation of the diagnostic performance of direct latex agglutination test (DLA), post-enrichment latex agglutination (LA) test, and direct culture on chromogenic media in rapid identification of GBS carrier in pregnant women in comparison with the conventional post-enrichment CDC-recommended culture method and further to estimate GBS carriage prevalence and its antimicrobial susceptibility.MethodsTwo hundred pregnant women at gestational age (35–37 weeks) were enrolled. Three low vaginal swabs were obtained from each participant. One swab was directly inoculated into Strep B Select (SBS) agar. The second swab was inoculated in enrichment Lim broth for immunological antigen detection by post-enrichment latex agglutination (5 h and 24 h) and subculture for bacteriological detection. The third swab was used for immunological detection of GBS antigen by direct latex agglutination. The isolated GBS was subjected to antimicrobial susceptibility testing.ResultsAmong 200 pregnant women, 47 (23.5%) were GBS carriers. Considering post-enrichment subculture on SBS medium as a gold standard, the sensitivities for post-enrichment 5 h and 24 h LA were 66% and 95.7%, respectively. However, direct cultivation of the vaginal swabs on SBS medium and DLA recorded 83% and 4.3%, respectively, for sensitivity. All GBS isolates (100%) were sensitive to penicillin G, ampicillin, ceftriaxone, and vancomycin. In contrast, 21.3% and 12.8% of isolated GBS were resistant to erythromycin and clindamycin, respectively.ConclusionGroup B streptococcal antigen detection by latex agglutination after 5 h enrichment is a reliable, easy, and relatively rapid method for screening of GBS carriage in pregnant woman not in labor. Latex agglutination after 18–24 h enrichment can be used alternative to standard subculture method for screening GBS carriage.

Background: Chronic Spontaneous Urticaria (CSU) is a common health problem and its clear etiology is not established yet. Several theories have been tried to illustrate its etiology and pathogenesis. Autoantibodies and inflammatory cytokines like IL-23 and IL17 are hypothesized to take part in CSU pathogenesis and outcome. Objectives: To detect serum levels of IL-23 and IL-17A among CSU patients and to determine its correlation with disease severity and its relation to autoreactivity. Methodology: Serum levels of IL-23 and IL-17A were measured in 23 patients with CSU (CSU group) and 23 healthy controls (control group). In CSU group, Weekly Urticaria Activity Score (UAS7) was recorded to assess disease severity. Autologous Serum Skin Test (ASST) was performed to assess autoreactivity. CSU patients᾿ group was subdivided, based on ASST, into positive ASST (ASST+ ) and negative ASST (ASST- ) subgroups. Correlation of serum IL-23 & IL-17A levels, with UAS7 and ASST response were analyzed. Results: CSU group had higher serum IL-17A and IL-23 levels than control group (P=0.000). ASST+ CSU had higher serum IL-17A and IL-23 levels than ASSTones (P=0.000). Additionally, UAS7 was higher in ASST+ subgroup than ASST- subgroup (32+11.7 versus 16.27+ 9.92; P =0.005). There was significant positive correlation between disease severity and serum levels of both IL-17A and IL-23 among CSU patients (r= 0.626 & P= 0.001 and r=0.515 & P= .012, respectively). Conclusion: Increased serum IL-17A and IL-23 levels may constitute two major determinants of CSU pathogenesis and severity.

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BACKGROUND: The most commonly used prognostic factors in acute myeloid leukemia (AML) are cytogenetic, molecular, and morphological markers. However, AML prognosis is still unfavorable particularly in adults. So, further reliable markers are urgently needed to improve the risk stratification and treatment decisions. CUB domain-containing protein 1 (CDCP1; CD318) and endoglin (CD105) are new markers correlated with poor prognosis in different solid tumors, but their role in AML prognosis is not fully evaluated. OBJECTIVES: This work aimed to evaluate the prognostic role of CD318 and CD105 in AML and their impact on the outcomes. METHODS: Sixty-five newly diagnosed AML patients were included in this study. CD318 and CD105 expression was assessed by quantitative real-time polymerase chain reaction. Patients were followed up for ∼ 2 years to evaluate the prognostic impact of gene expression on the outcomes. RESULTS: Patients with high CD318 and CD105 showed higher white blood cell (WBC) count, M2 subtype, poor cytogenetic risk, reduced complete remission, and a greater number of deaths compared to low CD318 and CD105. CD318 was correlated with CD105, and both were correlated with WBC count, bone marrow blasts, and peripheral blood blasts. After a follow-up period of up to 24 months, relapse-free survival for high CD318 and CD105 was significantly different (42.1% and 52.6% vs. 64.5% and 58.1% for low CD318 and CD105, respectively). Survival was worse in patients with high CD318 and CD105, as the mean survival time was 13.9 and 13.3 months compared to 24 and 22.7 months in low CD318 and CD105, respectively. CONCLUSIONS: CD318 and CD105 are upregulated in AML patients. Their overexpression was associated with poor response to treatment and poor outcomes. Therefore, CD318 and CD105 can be useful prognostic markers in AML.